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News & Views

This article is the first in a series of articles that will highlight Kaiser Permanente’s approach to building healthy communities through Healthy Eating Active Living collaboratives, a program developed by Kaiser Permanente’s Community Benefit organization.

Kaiser Permanente has long recognized the connection between health and place — maintaining good health is easier when people are surrounded by healthy choices in their schools, workplaces, and neighborhoods. Yet, building healthy surroundings for people is not an effort that can be led by one individual or organization alone. It is a collaborative effort that must involve the whole community.

Fortunately, health care professionals, policymakers, and community activists are increasingly joining forces to find solutions to the nation’s health crisis — particularly as obesity and chronic disease rates continue to increase in the United States. This coalescing of partnerships across disciplines has given rise to a relatively new approach to public health, one that involves a focused, collaborative effort to transform the very places where people live, work, and play.

Seven years ago, Kaiser Permanente created Community Health Initiatives for Healthy Eating and Active Living, a program of Community Benefit. At the center of Community Health Initiatives are HEAL collaboratives. These collaboratives represent a community-based approach to wellness that seeks to make changes at multiple levels — environmental and policy changes, individual behavior changes, increased community engagement and community ownership — to bring about improved health outcomes.

Through strategic grant-making efforts, community partnerships, and the mobilization of a diverse array of stakeholders, Kaiser Permanente initiates and supports HEAL interventions across the country to help communities realize their vision for change.

A National Effort

Today, Kaiser Permanente is the principal sponsor or co-funder of more than 40 HEAL collaboratives across California, Colorado, Georgia, Ohio, the Pacific Northwest, and the Washington, D.C., area. In Northern California, Kaiser Permanente recently announced a 3-year, $10 million investment of new funding for seven HEAL communities or “HEAL Zones” across their region. Similarly, Southern California is planning to roll out funding for three new collaboratives in late 2011. Since 2004, Kaiser Permanente has committed more than $50 million to support HEAL collaboratives.

“The places where we live, work and go to school have an enormous impact on our health,” said Loel Solomon, PhD, vice president of Community Health at Kaiser Permanente. “Our HEAL collaboratives acknowledge the power of place and help bring Kaiser Permanente’s approach to total health beyond the walls of our medical office buildings.”

HEAL collaboratives have two primary aims: to make substantive improvements in the health of a community population, and to increase the community’s capacity to sustain those health improvements over time.

The work entailed in reaching these goals is complex and multifaceted, requiring substantial planning and assessment of current conditions. It involves engagement and relationship-building with community partners, as well as rigorous evaluations to assess the impacts being made. And it requires community organizing to build public will and to engage residents in community change efforts.

Who We Help

HEAL sites are selected based on an identified need for health improvement and their readiness to engage in the collaboration. Most are urban cities or small towns, although some are rural. They are often ethnically diverse, low-income communities with high rates of chronic, yet preventable, diseases.

Kaiser Permanente works with community partners to decide which health-improvement strategies to implement based upon an understanding of a community’s needs, assets, and opportunities for change. Common strategies include:

Community Action Plans also typically include educational activities, awareness-building strategies, and programs to promote physical activity and healthy eating.

The Impact of Our Work

What kind of impact have these collaboratives had? A recent assessment in Kaiser Permanente’s Northern California and Colorado regions showed significant increases in the percentage of residents who now have access to walkable and bikeable neighborhoods, healthier school food policies, fresh food outlets, and other health improvements. The assessments also show significant improvements in behavior that supports prevention of chronic disease-related illness.

As HEAL collaboratives have expanded and evolved, so has the need to share experiences and lessons learned. In June, many of Kaiser Permanente’s collaborative leaders from across the regions gathered in San Diego prior to the 2011 Biennial Childhood Obesity Conference.

Leaders who attended discuss the challenges and opportunities they experienced doing HEAL collaborative work in their communities. Several attendees at the meeting shared their perspectives and expressed enthusiasm for being a part of Kaiser Permanente’s HEAL intervention work.

Coming up in this series: Highlights of the unique challenges and accomplishments in three different HEAL communities in our Northern California, Colorado, and Mid-Atlantic States regions.